Trachoma in Groot-Atjeh — or rather its absence — was the eighth question of Dr. C. E. Gomperts’s eye survey of 1937. His conclusion was categorical: trachoom according to the generally current conception did not occur in the surveyed area of Groot-Atjeh. What was found instead was conjunctivitis follicularis, a distinct and benign condition of childhood.
Conjunctivitis follicularis
Although this condition often gave rise to differential-diagnostic difficulty with trachoma, the form Gomperts observed among the Atjehnese population presented no difficulty in any respect. He gave four grounds:
- this form of conjunctivitis was observed exclusively in children, and in adults very rarely;
- in none of the 215 cases found were corneal complications present, nor in the few adult cases;
- the korrels (granules) occurred either in the lower transitional fold and the conjunctiva tarsi inferior alone, or in both transitional folds and both conjunctivae tarsi, but never above alone — and though it could not be traced whether in the both-above-and-below cases the granules had manifested themselves first above, the fact that they occurred isolated below but never isolated above made that possibility very slight;
- had this form belonged to trachoma, it might have been expected to occur most in the districts with busy traffic and with admixture of other indigenous races — Javanese, Padangers, Malays — among whom trachoma did occur in its typical form. Such districts were Lho-Nga, Oelee-Lheuë, Seulimeum and Kroeëng-Raja. In Oelee-Lheuë 78 cases were found among 1,325 children (6 per cent); but in Moekim Montassie, with an exclusively Atjehnese population, 75 cases were found among 1,795 children (rather more than 4 per cent) — so that the expected concentration in mixed and busy districts did not appear.
Rejection of the benign-trachoma theory
“De meening van sommigen dat deze vorm van conjunctivitis een goedaardige vorm van trachoom bij de jeugd is, die tot zelfgenezing neigt zonder resttoestanden achter te laten, mist volgens schrijver elken grond” — the opinion of some, that this form of conjunctivitis is a benign form of trachoma in the young which tends to self-healing without leaving residual conditions, lacks in the writer’s view every ground. With certainty, based on his own investigations, it could be said that no trachoma occurred among the Atjehnese population of the surveyed area.
The tabulated cases numbered 215 in all — 35 boys and 92 boys by site, 40 and 48 girls — about 2 per cent of the 11,400 children examined. Gomperts had the impression that the condition occurred more among boys than girls.
Consequence for the causes of blindness
The absence of trachoma had a direct bearing on the analysis of blindness. Gomperts noted that the K.W.-infection, which according to Egyptian statistics could lead to blindness, left room for doubt, since trachoma — an important cause of blindness — also occurred very frequently in Egypt; in Groot-Atjeh that cause could certainly be switched off, and the possibility need not be reckoned with.
Contrast with the Batak country
The finding stands in contrast with the experience of Dr. J. Tijssen on Samosir in 1933, where among the candidates for treatment there was not a single cataract “maar trachoom en nog eens trachoom” — but trachoma and again trachoma.
See Also
- Trachoma
- Blindheid in Groot-Atjeh
- C. E. Gomperts
- J. Tijssen
- Oriënteerend oogheelkundig onderzoek bij de Atjehsche bevolking van Groot-Atjeh gedurende 1937
Source
Oriënteerend oogheelkundig onderzoek bij de Atjehsche bevolking van Groot-Atjeh gedurende 1937 (“Orienting Ophthalmological Survey among the Atjehnese Population of Groot-Atjeh during 1937”), by Dr. C. E. Gomperts, offprint from the Geneeskundig Tijdschrift voor Nederlandsch-Indië, Afl. 19, Deel 80 (1940), pp. 1191-1238 (Batavia-Centrum: G. Kolff & Co.). Received by the editors 25 October 1939. Offprint DLP-157, Bibliotheek KITLV.